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The Definition, Diagnosis, and Management of Growth-Discordant Twins: An International Census Survey

Published online by Cambridge University Press:  01 August 2014

I. Blickstein
I. Blickstein*
Affiliation:
Department of Obstetrics and Gynecology, Kaplan Hospital, (affiliated to the Hadassah-Hebrew University School of Medicine, Jerusalem), Rehovot, Israel
*
Department of Obstetrics and Gynecology, Kaplan Hospital, 76100 Rehovot, Israel.

Abstract

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In order to establish a protocol considering the definition, diagnosis, and management of growth-discordant twin gestations, a questionnaire was sent to 96 authors of twin-related obstetric articles. The views of the 61 responders comprise this international census survey. The data suggest that a clear cut-off value for discordancy is still needed; however, the data indirectly supported a two-grade definition, namely, mild (> 15% and < 25% birth-weight disparity) and severe (> 25%) growth discordants. Expectant management was advocated by the majority of participants with out-patient follow-up for mild discordants, while severe discordants may preferably be hospitalized. Follow-up should be done by non-stress testing (daily - 2/wk), biophysical profile (1-2/wk), Doppler velocimetry (1/wk - bi-weekly) and sonographic biometry (bi-weekly). The opinions considering termination of pregnancy because of intertwin growth discordancy were divided; however, discordancy per se, was not considered an indication for cesarean delivery. An adapted management flowchart that summarizes the survey's data is presented and may be used as a standard for future investigations.

Keywords

TwinsPregnancyDelivery management
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 40 , Issue 3-4 , October 1991 , pp. 345 - 351
Copyright
Copyright © The International Society for Twin Studies 1991

References

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